The Cardiac Cycle, Animation
3-D Images Help Cardiologists End Heart Rhythm Chaos
New 3-D images dramatically improve surgery outcomes for patients with Atrial fibrillation, researchers reported Saturday.
By Jennifer J. Brown, PhD
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SATURDAY, May 11, 2013 —A new 3-D imaging system that maps hidden heart defects appears to have given cardiologists the high-tech tool they need to dramatically improve the success rate of procedures to correct serious heart rhythm irregularities.
Researchers from Intermountain Medical Center reported today that surgeries performed with the help of the new images successfully relieved the symptoms of advanced Atrial fibrillation, or Afib, in 79 percent of the patients treated — compared to a success rate of only 47 percent among patients whose surgery was performed without the images.
Afib affects three million people in the U.S., causing them to have irregular, fast heartbeats that can result in lightheadedness, fatigue, shortness of breath and chest pain. In most cases it can be controlled with drugs. But if the drugs fail, surgery performed with a heart catheter that freezes or burns defective sections of the heart is often indicated.
The problem for cardiologists has been knowing where exactly to freeze or burn. The new technology maps the heart’s electronic signals into 3-D images which allow doctors to more precisely zap the problem areas, which in turn can get patients’ heartbeats back to a normal rate and rhythm.
“Afib is complete electrical chaos,” said lead study investigator, John Day, MD, Director of Heart Rhythm Services at Intermountain and Vice President of the Heart Rhythm Society, at whose meeting in Denver the new system was described. “The beauty of the new technique is we are making sense of the chaos. We see the source of the chaos to treat the source and get better outcomes.”
"3-D Imaging for Catheter Ablation will help more physicians to perform the procedure because it will increase the odds that the catheter will be properly placed when used," said healthcare expert Myrtle Potter, President and CEO of Myrtle Potter & Company, LLC., and a member of the Everyday Health Board of Directors. Potter noted, however, that "catheter ablation is only appropriate first-line therapy in somepatients with afib."
The Intermountain team used experimental 3-D imaging to treat 49 patients’ hearts In 2012 and earlier this year and compared the results to those of 200 control patients who were treated with the normal standard of care. Medication had failed to regulate the heart arrythmias of all of the patients, who were then given surgery.
“By treating the source using this new mapping technology we were able to dramatically improve success of the surgery,” Dr. Day reported. Even more importantly, the benefit lasted. One year later, 79% of patients’ hearts were back to normal after 3-D imaging and surgery, compared with only 47% of those who didn’t get the 3-D imaging but had the surgery.
If the results are confirmed, the new catheterization technique will offer a new option for patients who don't respond to drug therapy, but who are not ready for conventional and more invasive surgeries.
Improving Treatment for Advanced Afib
“We are facing an epidemic of Afib,” Dr. Day said, “A huge number of patients have more advanced stages and this is the group we really struggle with. It is likely there are more patients with advanced stages than early stages of disease,”
Afib treatment costs are estimated at more than billion each year, and the condition incidence is on the rise, according to the CDC. The challenges faced by patients with atrial fibrillation really vary based on many factors, including age, other medical issues they might have, the duration of atrial fibrillation, and how they feel. Every patient is different, says Reena Pande, MD cardiologist at Harvard Medical School in Boston and medical director of the Vascular Diagnostic Laboratory at Brigham and Women's Hospital. When left untreated, or where drug therapy fails, patients suffer from stroke and heart failure. on the rise, according to the CDC. “The challenges faced by patients with atrial fibrillation really vary based on many factors, including age, other medical issues they might have, the duration of atrial fibrillation, and how they feel. Every patient is different,” says Reena Pande, MD cardiologist at Harvard Medical School in Boston and medical director of the Vascular Diagnostic Laboratory at Brigham and Women's Hospital. When left untreated, or where drug therapy fails, patients suffer from stroke and heart failure.
Doctors check for Afib by giving patients an electrocardiogram, or EKG, to show the electrical activity of the heart. Treatment aims to control the irregular heart rate, the chaotic heart rhythm, and to prevent stroke with medication like blood thinners, or with surgery.
Video: Cardiac Output, Stroke volume, EDV, ESV, Ejection Fraction
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